OCT imaging shows promise for oral cancer diagnosis

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The first quantitative results from a study on the use of multi-beam OCT imaging for oral cancer diagnosis have been presented at the Second Scientific Meeting of the Head and Neck Optical Diagnostics Society (HNODS), held in San Francisco, 23-24 January, as part of SPIE Photonics West.

The presenting authors, Professor Colin Hopper, Dr Waseem Jerjes, and Zaid Hamdoon of University College Hospital London, concluded from the study that multi-beam OCT imaging will be a very useful clinical diagnostic tool for early diagnosis of oral cancer and for measurement of tumour resection margins in oral cancer.

In the study, the University College Hospital team studied OCT images, collected using a Michelson Diagnostics EX1301 multi-beam OCT microscope, of excised biopsy samples from 120 patients with suspicious lesions. They developed a set of image markers of cancer from a small training set, and then did a blinded analysis, arriving at a sensitivity of 80 per cent and specificity of 81 per cent for diagnosis of cancer, vs. the 'gold standard' of histopathology. They also analysed the use of OCT for tumour margin measurement, by a similar blinded analysis of multi-beam OCT images, of 112 excised resection margins from 28 oral cancers, arriving at sensitivity of 86 per cent and specificity of 88 per cent vs. histopathologist assessment.

'These ex-vivo results are very encouraging,' said Professor Hopper, 'and we expect the in-vivo results to be even better, due to better contrast on perfused tissue.'

Orpington, UK based Michelson Diagnostics launched its VivoSight multi-beam OCT scanner with hand-held probe for in-vivo use on skin during 2009. Jon Holmes, CEO of Michelson Diagnostics, said: 'This is a remarkable milestone for Michelson Diagnostics, as it shows, through a statistically significant sample, that multi-beam OCT technology has the potential to play an important role in the early diagnosis of cancer.'

More than 400,000 cases of oral cancer are reported annually, worldwide (source: WHO), and the survival rate remains poor: less than 50 per cent survive 5 years, after diagnosis, in the UK.

According to Professor Hopper, early diagnosis is key to improving chances of survival: 'If we can catch it early, the incipient tumour is small and can be easily excised, for a complete cure in most cases, but if it has been allowed to develop, the treatment is expensive, invasive, often disfiguring surgery, with a poor prognosis. We really need a fast, non-invasive way to scan the many lumps that develop in the mouths of users of tobacco, alcohol and betel nut, to see when one is developing a cancer – now, it really looks like OCT imaging is the answer.'

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